
The cost of staying alive could become a lot more expensive for millions of Americans because of Trump drug tariffs
In an effort to incentivize drug manufacturers to bring production back to the United States, Trump has proposed tariffing pharmaceuticals made overseas – which account for an overwhelming majority of everyday medicine used in the U.S.
'We're going to be doing that,' Trump said of pharmaceutical tariffs in April. 'That's going to be like we have on cars. You know we have a 25 percent tariff on cars, we have a 25 percent tariff on steel and aluminum, and that's what the [pharmaceutical] category fits right now.'
'The higher the tariff, the faster they come,' Trump said.
But experts say that's not necessarily true and there would be tangible consequences to such action, from higher brand-name drug prices to generic drug shortages.
'If tariffs were applied to prescription drugs, one of the most immediate consequences could be price increases — on prices that we already pay way in excess of other countries,' Dr. Mariana Socal, an associate professor at the Johns Hopkins Bloomberg School of Public Health, said.
The U.S. imports a majority of its branded prescription drugs – or medications that are patented with a brand name such as Viagra, Wegovy, or Zoloft – from high-income countries.
Dr. Jeromie Ballreich, an associated research professor at Johns Hopkins Bloomberg School of Public Health, said much of the manufacturing comes from Ireland, Germany, and Switzerland because they have favorable tax policies for companies.
As a result, adding a tariff would only make it more expensive for pharmacies and insurance companies to keep them in supply.
'We would expect pharma to pass the costs onto the insurers and we would expect insurers to pass the cost onto the individual patients,' Ballreich said.
'So, if there is a 50 percent tariff on your insulin product because it's coming from Ireland, patients in Mississippi who get insulin – they will either be faced with a higher cost when they go up to the pharmacy to fill their insulin or they're going to face a higher indirect cost because the premiums of the insurance plan are going to go up,' he said.
Ballreich said a tariff on countries that produce high quantities of branded drugs would put 'pressure' on public insurers like Medicare or Medicaid and private insurers.
However, branded drugs only account for roughly 10 to 15 percent of prescriptions. A majority of Americans, up to 90 percent, use generic drugs, often manufactured in India and China, because they're cheaper.
Making branded drugs less accessible through tariffs would only increase reliance on generic drugs, which could exacerbate shortages that already impact millions of Americans.
Generic drugs would become less available
'[Shortages] can have very significant implications in day-to-day clinical practice,' Socal said. 'For example, if you are administering chemotherapy for an oncology patient, that may have significant consequences even for the prognosis of that case moving forward.'
In 2024, the U.S. experienced a shortage of more than 300 drugs – 70 percent of which were generic prescriptions.
Socal said that when patients are not able to access a more affordable version of their prescription, it means they may put their health at risk by skipping a dosage, taking a lower dosage, or not filling their prescription at all. Otherwise, they're forced to turn to the more expensive branded version.
'Those more expensive drugs are not always the best,' Socal said. 'Very frequently, and we saw this with chemotherapy shortages, the available drugs are second-line drugs.'
Tariffs won't necessarily increase domestic manufacturing
The president has indicated that any negative impact from tariffs may be temporary and worth it to bring manufacturing and jobs back.
'We're doing it because we want to make our own drugs,' Trump said.
But Ballreich and Socal are more skeptical.
'Tariffs are a very blunt instrument to incentivize domestic U.S. manufacturing of the branded drugs we use,' Ballreich said.
Given pharmaceutical companies have moved outside of the U.S. for tax purposes, Ballreich says tax policy may be a better way to incentivize them, especially since many of those drugs are more difficult to manufacture.
'It's not just a very simple chemical plant; these tend to be very complex,' he said.
Socal suggested a better strategy would be to understand where drugs are being manufactured and which ones would make more sense to bring to the U.S. — since even those manufactured locally often rely on certain imported ingredients and materials.
'Having tariffs on pharmaceutical products coming from abroad can actually also hurt our domestic manufacturers,' he says.
While the president has not officially implemented any tariff policy on pharmaceuticals yet, he said, in April, that the plan would take effect in the 'not too distant future.'
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